Healthcare revenue cycle management - Cosentus

Healthcare revenue cycle management - Cosentus
11 min read
04 October 2023

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What is a Healthcare KPI?

A Healthcare Key Performance Indicator (KPI) or metric is a powerful tool used to monitor, assess, optimize, and transform healthcare processes. These metrics play a pivotal role in elevating patient satisfaction and operational efficiency for both healthcare providers and patients. Healthcare facilities employ KPIs to benchmark their performance against peers and identify areas for enhancement.

Why Your Business Should Embrace Healthcare Specific KPIs

In today's dynamic healthcare landscape, professionals must not only excel in their respective fields but also focus on delivering the highest quality care while optimizing hospital operations and managing costs effectively. The transition from paper to digital record-keeping has streamlined data management, reducing the risk of information loss and enhancing accessibility for care providers. Furthermore, this digital transformation has unlocked the potential for quantitative analysis, converting patient data into actionable key performance indicators in healthcare that can be tracked via dashboards or presented in reports to executives.

Now that you understand the potential of digital databases, let's delve into a curated list of the top 25 healthcare KPIs and metrics for your 2023 reporting.

Constructing Informative KPI Dashboards Operational Healthcare KPIs Operational healthcare KPIs focus on evaluating the performance of healthcare facilities. Improving these metrics can boost operational efficiency, thereby optimizing costs and elevating patient satisfaction.   Average Hospital Stay: This KPI tracks the average duration of patient hospitalization. To gain deeper insights, consider categorizing patients by treatment type, as different treatments may result in varying hospital stays. Such granularity allows for the identification of outliers related to unforeseen complications.   Calculation: Average Hospital Stay = Total Stay Duration / Total Number of Stays   Bed or Room Turnover: Monitoring how quickly patients move through the facility is crucial. This metric should be assessed alongside readmission rates to prevent premature discharges.   Calculation: Bed or Room Turnover = Number of Discharges (including deaths) / Number of Beds   Medical Equipment Utilization: This KPI measures the usage of advanced equipment, helping control costs associated with specialized tools and preventing overuse that may lead to maintenance issues and treatment delays.   Average Patient Wait Time: Patients often face long wait times in healthcare settings. This metric calculates the time a patient waits from check-in to provider consultation, offering insights for staffing and scheduling improvements.   Calculation: Average Patient Wait Time = Total Wait Time / Number of Patients  

Healthcare Financial Metrics

Financial healthcare KPIs analyze the fiscal aspects of healthcare facilities, encompassing treatment costs, claims, and human resources. They play a pivotal role in identifying and mitigating inefficiencies, impacting all areas of business operations.   Patient Drug Cost Per Stay: This often-overlooked metric assesses the cost of drugs administered during a patient's stay. Awareness of drug costs ensures affordability for patients and minimizes potential write-downs for the hospital.   Calculation: Patient Drug Cost per Stay = Total Drug Cost / Number of Stays   Average Treatment Charge: This KPI reflects the average treatment cost at your facility and gauges the effectiveness and efficiency of treatments. It can be further broken down by treatment type or category to guide cost reduction efforts.   Calculation: Average Treatment Charge = Total Treatment Charges / Number of Treatments   Insurance Claim Processing Time: Timely payment processing is essential. This metric monitors the time it takes for insurers to settle claims, impacting cash flow and accounts receivable management.   Claims Denial Rate: Assess the percentage of denied insurance claims, aiming for a rate below five percent to reduce paperwork and focus on patient care.   Calculation: Claims-Denial Rate (%) = (Number of Denied Claims / Total Number of Claims) * 100   Average Cost per Discharge: Tracking the average cost per patient discharged helps identify areas of overspending and revenue generation, facilitating long-term spending adjustments.   Calculation: Average Cost per Discharge = Total Cost of Discharges / Number of Discharges   Operating Cash Flow: This metric measures the revenue generated from routine operations, emphasizing the financial sustainability of healthcare facilities.   Calculation: Operating Cash Flow = EBIT + Depreciation – Taxes – Change in Working Capital   AR Turnover: Assess how efficiently the facility collects receivables, with a high turnover indicating timely payments and a low turnover suggesting collection issues.   Calculation: AR Turnover = Net Credit Sales / Average AR   Net Profit Margin: Evaluate the net profit margin, the ratio of net income to net sales, to ensure financial viability.   Calculation: Net Profit Margin = Net Income / Net Sales   Now that you've explored operational and financial healthcare metrics, let's discuss how healthcare dashboards can streamline your reporting.

Harnessing the Power of Healthcare Dashboards for Effortless Reporting

Healthcare facilities are bustling environments where staff face immense workloads. Simplify tasks for doctors, nurses, and administrators with specialized healthcare reporting software. Insightsoftware offers cutting-edge solutions that seamlessly integrate with your existing ERP, making KPI tracking and reporting effortless. Here are the advantages of using our healthcare reporting software:   Automated Data Collection: Say goodbye to manual data collection inefficiencies and errors. Our healthcare reporting solutions automatically extract and process data from your ERP for your dashboard.   Centralized Data: Centralize patient data for easy access and informed decision-making. Our healthcare KPI dashboard consolidates essential data, providing instant access when needed.   Pre-built KPI Templates: We understand the time constraints in healthcare. That's why our software includes pre-built KPI templates that extract data from your ERP, saving you time and effort.   Effortless Reporting: All the heavy lifting is done for you. The data is automatically collected, centralized, and presented in a pre-built dashboard. Simply click "print" to generate reports.   If you're keen to explore the benefits of healthcare BI software further, request a free demo from us, and we'll showcase our software's capabilities. In the meantime, let's delve deeper into the diverse range of healthcare KPIs.

Monitoring Internal Processes with Healthcare Facility KPIs

Internal healthcare KPIs revolve around staff and internal processes. Effective staff management is critical for your organization's success. These KPIs complement operational and financial metrics, offering a holistic view of your facility's operations.   Error Rate: Evaluate the number of treatment errors made by staff when caring for patients. This metric is crucial for assessing staff effectiveness and is typically categorized by error type (e.g., medication, dosage, therapy).   Calculation: Error Rate (%) = (Number of Treatment Errors / Total Treatments) * 100   Training per Department: Proper training is essential in healthcare. Track the training received by staff in each department to ensure competence and patient safety.   Cancellation Rate: For outpatient clinics and hospitals, monitor the rate at which patients miss scheduled  appointments. Addressing this metric can enhance resource utilization and patient relationships.   Calculation: Cancellation Rate (%) = (Number of Missed Appointments / Total Number of Appointments) * 100   Readmission Rates: Assess the percentage of patients readmitted to the hospital for the same condition or complication. This metric helps gauge care quality and should be analyzed alongside error rates and training per department.   Calculation: Readmission Rate (%) = (Number of Readmissions / Number of Discharges) * 100   Patient Safety: Measure the hospital's ability to deliver quality care and prevent infections or complications post-operation. Tracking this metric is vital for process improvement and outbreak prevention.   Internal processes are pivotal in healthcare, directly impacting patient outcomes. Hence, a thorough evaluation of internal KPIs is essential. However, public healthcare metrics also play a crucial role.

Assessing Public Health Through Performance Metrics

Evaluating public health through performance metrics holds significant importance for the healthcare system as a whole. Educated populations receiving preventive care contribute to lower strain on emergency healthcare services.   Childhood Immunization Rate: Measure the percentage of children who receive immunizations, contributing to herd immunity and reducing the burden on healthcare centers.   Calculation: Childhood Immunization Rate (%) = (Number of Children Immunized / Total Number of Children) * 100   Number of Educational Programs: Assess the number of education programs in various regions, as educated populations are more likely to seek preventive care. Categorize programs by type and target audience for detailed insights.   While preventive care reduces the burden on reactive healthcare systems, it's crucial not to neglect the reactive aspect.

Emergency Department KPIs

Emergency department KPIs focus on patient survival, helping understand when individuals seek emergency care and how efficiently the department operates.   Time Between Symptom Onset and Hospitalization: Measure the time elapsed from the onset of symptoms to hospitalization. Early hospitalization can identify and address conditions before they worsen, collaborating with educational programs.   Patient Mortality Rate: Though difficult to discuss, this metric assesses the percentage of patients who pass away in the hospital before discharge. A lower rate indicates better patient stabilization.   Calculation: Patient Mortality Rate (%) = (Number of Patient Deaths / Total Number of Patients) * 100   Emergency Room Wait Time: Evaluate the time patients spend waiting in the emergency room, helping identify peak hours and busy days for effective staff scheduling and life-saving measures.   Calculation: Emergency Room Wait Time = Total Wait Time / Number of Patients  

Care Quality Metrics in Healthcare

  Quality of care metrics are vital for patient satisfaction and reducing readmission rates. These metrics also serve as valuable marketing tools for organizations.   Staff-to-Patient Ratio: The quality of care directly depends on patient attention. Track the staff-to-patient ratio, ensuring a minimum standard for care quality.   Calculation: Staff-to-Patient Ratio = Number of Staff : Number of Patients   Patient Follow-Up Rate: Assess the number of patients receiving follow-up after their stay, impacting readmission rates. Higher follow-up rates often lead to lower readmission rates.   Calculation: Patient Follow-Up Rate (%) = (Number of Follow-Ups / Total Number of Patients) * 100   Overall Patient Satisfaction: This metric gauges patient satisfaction, serving as a valuable tool for organizational marketing. High satisfaction levels signal excellence, while low levels demand facility improvements.

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